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Frontal fibrosing alopecia (FFA) is an inflammatory disorder characterized by scarring alopecia of the frontotemporal scalp, thinning or loss of facial hair, and facial papules. Prompt treatment is essential to prevent permanent hair loss. Although studies have reported the efficacy of oral retinoids (isotretinoin and acitretin) in FFA treatment, a therapeutic role for alitretinoin is known only for lichen planus and not for FFA. Herein, we report a case of FFA accompanied with lichen planus that responded well to treatment with alitretinoin.

This study was undertaken to evaluate the clinical efficacy, safety, and histological changes induced by dietary omega-3 fatty acid and γ-linoleic acid in acne vulgaris. A 10-week, randomised, controlled parallel dietary intervention study was performed in 45 participants with mild to moderate acne, which were allocated to either an omega-3 fatty acid group (2,000 mg of eicosapentaenoic acid and docosahexaenoic acid), a γ-linoleic acid group (borage oil containing 400 mg γ-linoleic acid), or a control group. After 10 weeks of omega-3 fatty acid or γ-linoleic acid supplementation, inflammatory and non-inflammatory acne lesions decreased significantly. Patient subjective assessment of improvement showed a similar result. Heamatoxylin & eosin staining of acne lesions demonstrated reductions in inflammation and immunohistochemical staining intensity for interleukin-8. No severe adverse effect was reported. This study shows for the first time that omega-3 fatty acid and γ-linoleic acid could be used as adjuvant treatments for acne patients.

Introduction Among non-ablative devices for wrinkle reduction and skin laxity, long pulsed 1064 nm Nd:YAG laser (LPND) has considerable effectiveness. It can penetrate to deep dermis due to its longer wavelength. This study assesses the efficacy and safety of LPND applying new parameters for skin rejuvenation in Korean subjects. Methods A prospective randomized split-faced study was done (n = 20). Half of the face was treated with three passes of LPND at a spot size of 12 mm, 20–24 J/cm 2 fluence, 12 ms width, and frequency of 2 Hz, for three sessions, every four weeks. Outcomes were measured by wrinkle evaluation of blinded investigators, subjects’ self-assessment, objective measurements of elasticity, and skin biopsy. Results Four weeks after the final treatment sessions, the average wrinkle grades of the treated side were reduced by 45.1%. Skin elasticity was significantly increased. The increment of collagen and elastic fiber in papillary dermis was confirmed histologically. No adverse reaction was reported. Pain on the treated side was mild without needing anesthesia. Discussion The authors studied new parameters for LPND for improvement of wrinkles and skin laxity with fewer treatment sessions without serious complications. Histologic findings corresponded to clinical improvement. Conclusion New parameters of LPND can achieve wrinkle improvement with few side effects.

Background Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in women of childbearing-age. Although PCOS has common dermatological manifestations, including hirsutism, acne and androgenetic alopecia, little is known about the dermatological characteristics of PCOS patients in Asia. Objective The goal of this study is to elucidate the dermatological characteristics and metabolic and hormonal parameters of Korean PCOS patients classified by the three ASRM/ESHERE criteria. Methods We investigated 40 untreated PCOS patients who were newly diagnosed in the Department of Obstetrics & Gynecology of Seoul National University Hospital. Patients were classified according to the presence of irregular menstruation (IM), polycystic ovary morphology (PCOM) and hyperandrogenism (HA). Acne specific questionnaire, physical examination, and blood sampling were thoroughly conducted. Results Twenty four patients (60.0%) met the criteria for the IM/HA/PCOM group and sixteen (40.0%) belonged to the IM/PCOM group. Acne was the most commonly observed dermatological manifestation (95.0%) followed by hirsutism (60.0%), seoborrhea (47.5%), acanthosis nigricans (20.0%) and androgenetic alopecia (12.5%). Hirsutism was more frequently observed in the IM/HA/PCOM group; the prevalence of other cutaneous manifestations did not differ significantly. Acne was most often observed on the face and most acne lesions were distributed on the forehead and cheek. Serum dehydroepiandrosterone sulphate level was higher in IM/HA/PCOM group, while serum cholesterol and high density lipoprotein concentrations were higher in the IM/PCOM group. Conclusion We described several dermatological manifestations and serum hormonal and metabolic parameters in Korean PCOS patients. Cutaneous manifestations might be the first signs of PCOS; therefore, dermatologists should be more aware of cutaneous manifestations of various ethnicities.

Various methods of photodynamic therapy (PDT) for acne have been introduced. However, comparative studies among them are still needed. We performed this study to compare the effect of methyl aminolevulinate (MAL) PDT for acne between red light and intense pulsed light (IPL). Twenty patients were enrolled in this eight-week, prospective, split-face study. We applied MAL cream over the whole face with a three-hour incubation time. Then patients were irradiated with 22 J/cm(2) of red light on one-half of the face and 8-10 J/cm(2) of IPL on the other half during each treatment session. We performed three treatment sessions at two-week intervals and followed-up patients until four weeks after the last session. Inflammatory and non-inflammatory acne lesions were reduced significantly on both sides. The red light side showed a better response than the IPL side after the first treatment. Serious adverse effects after treatment were not observed. MAL-PDT with red light and IPL are both an effective and safe modality in acne treatment. Red light showed a faster response time than IPL. After multiple sessions, both light sources demonstrated satisfactory results. We suggest that reducing the total dose of red light is desirable when performing MAL-PDT in Asian patients with acne compared with Caucasians.

Recent studies have suggested that dietary factors, specifically glycaemic load, may be involved in the pathogenesis of acne. The aim of this study was to determine the clinical and histological effects on acne lesions of a low glycaemic load diet. A total of 32 patients with mild to moderate acne were randomly assigned to either a low glycaemic load diet or a control group diet, and completed a 10-week, parallel dietary intervention trial. Results indicate successful lowering of the glycaemic load. Subjects within the low glycaemic group demonstrated significant clinical improvement in the number of both non-inflammatory and inflammatory acne lesions. Histopathological examination of skin samples revealed several characteristics, including reduced size of sebaceous glands, decreased inflammation, and reduced expression of sterol regulatory element-binding protein-1, and interleukin-8 in the low glycaemic load group. A reduction in glycaemic load of the diet for 10 weeks resulted in improvements in acne.

Background: Empathy is an important element of professionalism in medicine. Thus, evaluation and enhancement empathy in physicians is important, regardless of geographical boundaries. Aim: This study was designed to evaluate the psychometrics of a Korean version of the Jefferson Scale of Physician Empathy (JSPE) among Korean physicians. Methods: The Korean version of JSPE was completed by 229 physicians in Korea. Results: Item-total score correlations were all positive and statistically significant. Cronbach’s coefficient alpha was 0.84. The mean score was 98.2 (SD ¼ 12.0), which was lower than that reported for American and Italian physicians. The emerged factor structure of the translated version was somewhat similar to that reported for American physicians, although the order was different. Significant differences in the mean empathy scores were observed between men and women and among physicians in different specialties. Conclusion: Our findings provide evidence in support of reliability and construct validity of the Korean version of JSPE for assessing empathy among Korean physicians. The disparity between Korean physicians and physicians from other countries may be explained by differences in the culture of medical education and medical practice. It suggests an exploration of cross-cultural differences in physician empathy.

Pacinian corpuscles are sensory nerve-end organs located in the deep dermis and subcutaneous tissue of the palms or soles. Pacinian neuroma is an extremely rare feature, defined as hyperplasia or hypertrophy of Pacinian corpuscles. About half of Pacinian neuromas present with point tenderness. There have been a limited number of cases reported around the world. We observed a 45-year-old woman with an 8-month history of a tender whitish papule on her left thumb tip. Histopathologically, an enlarged hypertrophic Pacinian corpuscle in subcutaneous tissue, surrounded by numerous nerve fibers, was found. Herein, we report a case of Pacinian neuroma presenting as a tender papule on a fingertip that was clearly related to repetitive trauma at that site. This case shows that a meticulous history and histological examination can lead to an exact diagnosis and proper treatment.

Acne treatments using laser and light devices have been reported to have varying degrees of efficacy. However, there has been no study of treatment of acne using a dual mode (quasi-long pulse and Q-switched mode) 1064-nm Nd:YAG laser assisted with a topically applied carbon suspension.To evaluate the clinical efficacy, safety, and histological changes of new laser treatment method for acne vulgaris.Twenty-two patients received 3 sessions of quasi-long pulse and Q-switched Nd:YAG laser treatment assisted with a topically applied carbon suspension at 2-week intervals in a randomized split face manner.At the final visit, the inflammatory acne lesions were reduced on the laser-treated side by 58.6% (P.001), but increased on the untreated side by 5%. The noninflammatory acne lesions were reduced on the laser-treated side by 52.4% (P.001). Sebum output reduction, inflammatory cell and cytokine reductions, a decrease of the thickness of a perifollicular stratum corneum and a full epithelium, and skin rejuvenation effect were found. The histopathologic examination of the acne lesions showed decreased inflammation and immunostaining intensity for interleukin 8, matrix metalloproteinase-9, toll-like receptor-2, and nuclear factor kappa B, and tumor necrosis factor alpha was reduced significantly. No severe adverse reactions were reported. All patients reported mild transient erythema that disappeared in a few hours.The number of subjects studied was small.This laser treatment was rapid and effective for treating not only the inflammatory but also the noninflammatory acne lesions when compared with the control side. The histopathologic findings correlated well with the clinical acne grade and treatment response. This novel laser treatment appears to be safe and effective for acne treatment.

The association between acne and food has been evaluated with inconsistent results. We enrolled 783 patients with acne and 502 control subjects. For the patients with acne, blood tests for insulin, insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), post prandial 2 hours blood glucose (PP2), and dehydroepiandrosterone sulphate (DHEAS) were performed. The acne patients were divided into an "aggravated by food" group (AF) and a "not aggravated by food" group (NAF). All participants were asked to fill out a questionnaire. The frequency of vegetables (yellow, green leafy, cruciferous) (P = .001) and fish (white flesh and green fish, blue tuna) ((P = .03) intake was significantly higher in the control group than in the acne group. Intake of instant noodles (P = .01), junk food (P = .002), carbonated drinks (P = .005), snacks (P = .001), processed cheeses (P = .04), pork (braised) (P = .02), pork (roast) (P.001), chicken (fried) (P = .001), chicken (stewed) (P = .001), nuts (P = .002) and seaweed (P = .003) were significantly higher in the acne patients than in the controls. Intake of roast pork (P = .02), fried chicken (P.02), and nuts (P = .03) was significantly higher in the AF than NAF. In addition, the regularity of inter-meal intervals (P.001) and breakfast intake (P.001) were significantly lower in the acne patients. IGF-1 and IGFBP-3 showed sexual differences. This study also showed that a high glycemic load diet, dairy food intake, high fat diet, and iodine in Korean foods appear to play a role in acne exacerbation. In addition, irregular dietary patterns were found to aggravate acne.